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APPLICATIOAFOR CONSTRUCT& PERMIT <br />CITY OF EVERETT A BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br />I I DEMOLITION n COMBINATION OBUILDINO fl MECHANICAL : I PLUMBING i SIGN <br />PROJECT ADDRESS <br />3003 lN. G/}slNo 2D yo-91 <br />0.86,K37ol NS 0ff-13 317A-/f Lr. W!f- <br />AACMRCT CP IXSKIN[R MAIL ADDRESS tlA n PI1pl1[ <br />,+r c vls(OA).1173'7 A-DA1I0(crmar'dfJ Om.. Srexo1 AAo Iawt. Of0gol-24-rS <br />G.E. SA),bat,+S5139A1 NIw1u 1nn,SAVC.1 Pa n,10--lbM 9-212 (S'o1)28a-72s S <br />MEaAMCIY 0ON7RACi011 MAN ADDRESS an !M Aldt STATE IKFNSF• <br />A I)Nlp CdiRAfla MAR ALCO[S! CIA PT, AIONF STATE LKENYA <br />caNTMCT.ACEvwaM 7-�'T000 <br />HEATINOBYSTEM: IIOAS (•)ELECTRIC rl <br />DExmRr RonR •No nO11ARF roDTAaF INwIv[P <br />/L ATE A=�FI/4 $PII-LE ti <br />carrtAct PFRS011 AMNMTNF NO <br />SDfY,JG C.G602Y UNFOA� <br />L.EoNtf�-D �r�M�E/LSKA <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED MEREIN OR <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW iB 27 R///CW��ANND 296 200 WAD. <br />So-X •Fl / I l Z.)l/7_— <br />IN1olo>Eo uAE a wAonm <br />CYi-F �iGR-Y <br />IFOAtaSCAPTM Of PPOPERn ISIgYM MLava•rtALM TwocdKm <br />IDt xoa M <br />PARCFt TAF I n NIAAKA <br />CbNStRUCtgNIOANIFMIFR AnATFSR TILMAMTA"Fn <br />SNWATIIHE A, DATE <br />rity" FSSIFrWTq <br />PLUMBING <br />MECHANICAL _ <br />NO, TYPE OF E_WIPMENf FEE <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />WATER CLOSET (TOILET) <br />AC —A HNDLO UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />I <br />UNITHEATERS—BTU. M <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />, <br />DISHWASHER <br />VENTILATION FAN <br />_ <br />LAUNDRY TRAY <br />RANGE HDOD <br />' <br />CLOTHES WASHER <br />, <br />WATER HEATER <br />URINAL <br />WOOD STOVE <br />_ <br />DRINKING FOUNTAIN <br />1 <br />METAL FIREPLACE (WOOD BURNING) <br />FLOOR DRAIN <br />I <br />FIREPLACE INSERT (WOOD BURNING) <br />_ <br />BACKFLOW PREVENTERS <br />GAS FIREPLACE <br />SINK (SERVICE —BAR. ETC.) <br />OAS RANGE <br />GAS PIPING <br />I <br />EXHAUST FAN <br />SUB TOTAL t <br />' <br />SUB TOTAL <br />_ <br />PERMIT t <br />I <br />PERMIT ! <br />I <br />TOTALFEE 81 <br />TOTAL FEE t <br />FOR OFFICE USE ONLY: <br />rrMWT SFrnArY <br />rNAR <rinKw <br />/Ia A[tKA011 <br />AY1C11[a MlwlER <br />TEE <br />IEaFi NO <br />Da Fa.T <br />IOLAR[A <br />TIES ' VA( <br />I•[e rl w <br />EB <br />VALUATION <br />FE <br />euATIAR <br />D <br />trtpllrtMrAtpN <br />NO OF OAFLIAO <br />IIMte <br />FltlaRDYII <br />/(/A <br />nuunno <br />r'C AIAE,• AT, a SIAM! <br />OCCIA•NT LOAD <br />ILIA <br />PANIENt / <br />',"R ryFO <br />MlCNAMCAL <br />AMrNINAr AANCNFa <br />— <br />70 <br />nlARM11fOP <br />I" .REDO <br />RFASCN / <br />XS/^, <br />r1EAAENA/ <br />J f I4 <br />/PPOOYf' <br />OrMP <br />SrAIINIRD'NIISInCNAII(f <br />Sv <br />rrRE r.OISr <br />1.;-- tl,CN, <br />r <br />AANS G4• <br />W/111 <br />at[ <br />CITY OF EVE=E:S <br />LOCAL SAOw <br />TAX CODE IS <br />